Provider Demographics
NPI:1003955147
Name:FITZGIBBONS, VALERIE ANN (MA CCCA)
Entity Type:Individual
Prefix:MRS
First Name:VALERIE
Middle Name:ANN
Last Name:FITZGIBBONS
Suffix:
Gender:F
Credentials:MA CCCA
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Mailing Address - Street 1:1776 YGNACIO VALLEY ROAD
Mailing Address - Street 2:SUITE 110
Mailing Address - City:WALNUT CREEK
Mailing Address - State:CA
Mailing Address - Zip Code:94598
Mailing Address - Country:US
Mailing Address - Phone:925-933-2699
Mailing Address - Fax:925-933-2797
Practice Address - Street 1:1776 YGNACIO VALLEY ROAD
Practice Address - Street 2:SUITE 110
Practice Address - City:WALNUT CREEK
Practice Address - State:CA
Practice Address - Zip Code:94598
Practice Address - Country:US
Practice Address - Phone:925-933-2699
Practice Address - Fax:925-933-2797
Is Sole Proprietor?:No
Enumeration Date:2007-02-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAHA3674AU1722237600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAAU0017220OtherSTATE OF CALIFORNIA
CAAU0017220OtherSTATE OF CALIFORNIA